Calcium and vitamin D supplementation to pregnant women in urban hospital and community settings
Authors
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Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016 ,IN
Amrita Pramanik -
National Institute of Nutrition, Hyderabad - 500 007 ,INRavindranadh Palika
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National Institute of Nutrition, Hyderabad - 500 007 ,INRaghu Pullakhandam
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Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016 ,INK. Kalaivani
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Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016 ,INPrema Ramachandran
DOI:
https://doi.org/10.21048/IJND.2023.60.1.31364Keywords:
Vitamin D deficiency in pregnancy, calcium and vitamin D supplementation, availability of calcium and vitamin D supplements, compliance with supplementation, impact of supplementationAbstract
In India, calcium intake is low and the prevalence of Vitamin D deficiency in pregnant women is high. The National Guidelines envisage elemental calcium 500 mg (as calcium carbonate salt) and 250 IU vitamin D supplements should be provided to pregnant and lactating women. In Delhi, iron folic acid tablets are given twice a day after meals in anaemic women and one tablet of calcium and vitamin D daily after a meal in all pregnant women. A study was taken up to assess the availability and compliance with calcium and vitamin D supplementation in primary health care institutions under research (Group 1 - 387 women) and service conditions (Group 2 - 400 women) and in urban community setting (Group 3 - 448 women). Women in Group 1 received Ca and Vitamin D tablets regularly from the research staff. In Group 2 and Group 3 tablets, were provided as and when government supplies were available and prescriptions were given when they were not available. Ca and Vitamin D tablets were expensive; families bought the tablets as and when they had the funds. As a result, the number of tablets available for consumption was lower in Group 2 and 3. In all three groups, side effects were rare and nearly all available tablets were consumed. In Group 1, Vitamin D estimation was done at enrolment and after supplementation for three months; 83% of women at enrolment and 68% of women after three months of supplementation had serum vitamin D levels below 20 ng/ml. These data suggest that one tablet of Ca and Vit D per day is insufficient for correcting maternal vitamin D deficiency. It is essential to carry out studies to assess the impact of supplementation with two tablets of Ca and Vit D on maternal vitamin D levels.
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Accepted 2022-11-24
Published 2023-03-01
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